JHC Dec 23

December 2023 Vol. 19 • No. 6

Women Leaders in Supply Chain

CONTENTS DECEMBER 2023 2 Publisher’s Letter: Musings from 20 Years of Publishing

4 Tackling Bill-Only Challenges More visibility for its implant device purchases helps Northwestern Medicine eliminate waste.

8 Walmart Health’s Big Push

The retail giant is quickly expanding its health centers and offering virtual care to its employees.

10 Amazon’s Reach Extends to Healthcare

After many forays into the market, the e-commerce giant acknowledges it can’t do it alone.

34 Partnering for Optimal Supply Chain Performance 36

Urgent Care Rollup

More urgent care chains have a tripledigit number of locations than ever before

38 Personalized Virtual Care

Leading health systems partner with consumer-focused platform for selfinsured employers to expand access to patients.

40

Feature

Women Leaders in Supply Chain  pg 12

Supply Chain By the Numbers

44 Distributors Partner with State and Local Preparedness Officials 46

Access to Medications

How GPOs prevent and mitigate drug shortages, while providing policy solutions to help combat them.

48 Industry News

Subscribe/renew @ www.jhconline.com : click subscribe

The Journal of Healthcare Contracting | December 2023

1

PUBLISHER’S LETTER

JOHN PRITCHARD

Musings from 20 Years of Publishing

The Journal of Healthcare Contracting is published bi-monthly

This issue concludes our 20th year of publishing The Journal of Healthcare Contracting. The world has changed greatly these past two decades, but the mission of this magazine has never been more poignant.

It’s crazy to think of the seismic challenges that have been thrown at us the last two decades: natural disasters like Hurricane Katrina, the financial crisis in 2008, the COVID-19 pandemic in 2020, global wars, social unrest and what seems like an ever-dividing political landscape.

Our healthcare industry has seen its share of challenges as well, including healthcare reform with the passing of the Affordable Care Act, industry consolidation, the evolving care setting, the growth and empowerment of payors and the emergence of many disruptors.

I can’t think of a more complex business than running an integrated health system in the best of circumstances, but when you pile all the above issues on top of the way providers are being graded and paid (more and more based off patient evaluations and outcomes) – the challenge is staggering.

And this brings me to what these past two decades have meant to our nation’s supply chain leaders. I’d contend during these unprecedented times that our corner of the world has more answered the call to supply our nation’s hospitals, facilities, and providers with what they need to give world class care.

by Share Moving Media 350 Town Center Ave, Ste 201 Suwanee, GA 30024 -6914 Phone: 770/263-5262 FAX: 770/236-8023 e-mail: info@jhconline.com www.jhconline.com

Editorial Staff Editor Graham Garrison ggarrison@sharemovingmedia.com

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Publisher John Pritchard jpritchard@sharemovingmedia.com

Circulation Laura Gantert lgantert@sharemovingmedia.com

I’ve had a front row seat to observe our nation’s most forward thinking and operating Supply Chain teams, and am always amazed at how they have evolved these past 20 years. Supplying our health systems has gone from an activity to a true discipline, from many lone soloists to finely harmonized symphonies.

One could make the argument that this growth has come from advanced technologies, progressed academia, or shared best practices, but there is no doubt in mind it is because of the people that lead and are in these supply chain teams.

For 20 years now our tagline has been Providing Insight, Understanding and Community.

This has been our calling and mission so we can play our part in the continued evolution of the U.S. Healthcare Supply Chain. It has been an honor to cover the great people in our nation’s health systems supplying their communities enabling world class care. And this is all enabled by all the readers of The Journal of Healthcare Contracting, so a heartfelt thank you for reading this magazine so we can play our part!

Cheers! Here is to the next 20 years!

The Journal of Healthcare Contracting (ISSN 1548-4165) is published monthly by Share Moving Media, 350 Town Center Ave, Ste 201, Suwanee, GA 30024-6914. Copyright 2023

by Share Moving Media. All rights reserved.

If you would like to subscribe or notify us of address changes, please contact us at the above numbers or address.

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Please note: The acceptance of advertising or products mentioned by contributing authors does not constitute endorsement by the publisher. Publisher cannot accept responsibility for the correctness of an opinion expressed by contributing authors.

2

December 2023 | The Journal of Healthcare Contracting

Where care begins While each patient journey is unique, medical diagnostics play a crucial role in delivering data and actionable insights.

At QuidelOrtho, we pride ourselves in providing these critical answers early and often in the healthcare continuum.

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MODEL OF THE FUTURE

BY DANIEL BEAIRD

Tackling Bill-Only Challenges More visibility for its implant device purchases helps Northwestern Medicine eliminate waste.

root problems through data analysis, user interviews and process mapping.

Casechek’s platform automates workflows for all of a health system’s vendor-supported procedures. It targets the implant supply chain with the same automation as stock supplies. With over 2 million surgical cases managed, it has a 97% average rep process compliance with an 80% reduction of manual labor during the process.

By specializing in healthcare’s complex implant supply chain, Casechek tackles Bill-Only challenges. Selecting the correct implant for a patient requires numerSome one in 10 Americans will have a medical device implanted into their

ous considerations by the surgeon based

bodies at some point in their lifetimes, according to the American Medical Association.

on their clinical judgement, training and

But one size does not fit all for implant devices.

experience. Surgeons often prefer specific brands or models of implants based on factors like clinical outcomes, longevity and ease of use.

tients require implants specifically suited

Northwestern Medicine and Casechek partner to co-develop a solution

for them, making procuring and paying

It’s a topic that Beringer, Northwestern

tem supply chain team can work with sur-

for patient-specific implants burdensome.

Medicine and Casechek are trying to get

geons to accommodate their preferences

The process is referred to as “Bill-Only.”

more people to pay attention to in healthcare.

while also valuing cost, standardization

But what does the Bill-Only process mean

Northwestern Medicine and Casechek

and patient safety. But procuring implants

So, health systems are unable to stock patient-specific implants because most pa-

Surgeon-driven implants can lead to higher costs and variation. A health sys-

were named the recipients of the 2023

can be left to the vendor and surgeon,

“I think a lot of people’s first question

SMI Tom Hughes Collaboration Award,

which leaves little oversight of implants

would be ‘what are Bill-Only’s,’” said Ali-

recognizing exceptional efforts of indus-

for the hospital and supply chain.

sha Beringer, director of supply chain for

try thought leaders collaborating to bring

Casechek developed the solution for

Northwestern Medicine. “I call it invisible

innovation, discovery and improvements

Northwestern Medicine after approaching

dollars. It’s such a pain point on the hos-

to the healthcare supply chain for their

Northwestern Medicine to help solve its

pital side. But when you tell people how

partnership to co-develop a solution to

Bill-Only problems. They wanted to build

much health systems can spend in prod-

the industry-wide challenge of process-

a tool for a customer, with a customer.

uct brought in by vendors, it’s staggering

ing and managing Bill-Only payments.

“That was music to my ears,”

how much money can flow through a

Northwestern Medicine and Casechek

Beringer said. “Casechek was willing to

system without visibility or tracking.”

worked together to uncover and solve

give us the resources and look at all of

to a health system’s bottom line?

4

December 2023 | The Journal of Healthcare Contracting

our data in its current state. They wanted

Casechek gave Northwestern Medicine

with Casechek in January 2022 after using

to understand us and build a certain tool

a team of people and spent time with

much of 2020 and 2021 digging into data

for us. We said absolutely.”

all of the positions and departments

and building the platform. The health system

involved in Northwestern’s Bill-Only

wanted it built so that data from the initial

process to help build a baseline. They dug

usage would lead them to improve.

Digging into the data, building the platform and going live

into the data and led the conversations

The COVID-19 pandemic hit soon after

“Casechek led the meetings, the

Northwestern Medicine started the pro-

project planning and the follow up with

cess, but they didn’t stop.

support from our team,” Beringer said.

“Procedures were down because of COVID-19, so people had more time on projects,” Beringer said.

between IT and the stakeholders.

“That was a huge win.”

Supply disruptions slowed the implemen-

Beringer said they wanted the data to answer key questions like:

` Is there a mismatch of data internally? ` Is there documenting during cases? ` Is the vendor putting wrong information in bills to begin with?

tation, but Northwestern Medicine went live “In 2021, our baseline was 8% in what we were seeing in our purchase order spend that wasn’t in the EHR,” she said.

“We’re now down to 0.25%.”

Some examples of savings include reusable products or products that can be sterilized multiple times but were being used one time. The amount of fees to vendors – to cancel a case or to use an item a vendor brings in, for example – are also tracked.

“We started asking how much money we are paying in fees,” Beringer said. “Are they contracted? Are we paying the right price? Those are visible costs we don’t document in EHR. Vendors could add a fee and we didn’t question it, we would just pay it. But now we have this tool, the visibility and the data.”

On average, Casechek says it finds $8.5 million in potential savings and errors from items undocumented in the EMR, unnecessary vendor fees and excessive ordering of reusable accessory items.

Casechek is consistently pushing Northwestern toward opportunities, Beringer explained. If a clinician is using a reusable item and spending a certain amount, for example, the health system should go back to that vendor and find a credit or rebate.

The Journal of Healthcare Contracting | December 2023

5

MODEL OF THE FUTURE

Getting vendors on the same page

If a vendor submitted after that time

platform and they were already set up

period, it created more work for staff and

with it. And we already had some interfac-

Plus, auditing and processing Bill-Only

it wasn’t charged if it wasn’t in the EHR.

es with Epic because of that platform, so

purchasing requests is time consum-

Now, those downstream impacts can be

it didn’t seem like we were starting from

ing and error prone. Since vendor bills

addressed directly with vendors.

ground zero. There were some big wins

are received after the surgery, the bill

Northwestern Medicine has conversa-

by partnering with them.”

and purchase orders must be reconciled

tions with vendors about expectations

The Bill-Only solution has expanded

against the hospital’s EMR and ERP.

and policies. If their reps are not serving

to other IDNs. To ensure it delivered value

Managing that process is complex and

Northwestern Medicine well financially or

to both IDNs and suppliers, Casechek and

manual for most hospitals.

in time spent, they may not be invited to

Northwestern Medicine requested feedback

support cases any longer.

from executives at over 25 IDNs and over

Beringer said there was nothing in previous contract language limiting a

“Casechek already had vendor relation-

10 device suppliers. The automated solution

vendor from submitting bills six months

ships, which was big,” she said. “A lot of

has significantly impacted the Bill-Only pro-

after a case. Northwestern Medicine posts

our implant vendors already knew Casechek

cess and led to several cost-related improve-

charges within a certain number of days.

because of their other procurement

ments aligning clinical and financial data.

SMI announces Northwestern Medicine and Casechek as 2023 Tom Hughes Collaboration Award Recipients SMI, a nonprofit, member-driven community of healthcare provider and industry partner organizations, awarded Northwestern Medicine and Casechek as the recipients of the 2023 SMI Tom Hughes Collaboration Award. The announcement and presentation of the award took place at the SMI Fall 2023 Forum in Nashville, Tenn.

The SMI Tom Hughes Collaboration Award is in honor of the late Tom Hughes, SMI Executive Director from 2004 to 2021. The Award Steering Committee chose SMI members Northwestern Medicine and Casechek for their collaborative partnership to co-develop a solution to the industry-wide challenge of processing and managing Bill-Only payments.

“Having known Tom Hughes for many years, this award is truly an honor for Northwestern and for our supply chain team,” said Gary Fennessy, vice president and chief supply chain officer at Northwestern Medicine. “This award demonstrates the power of collaboration when two partners work together to solve a complex problem and what can be accomplished when you persevere through a difficult and challenging process.”

6

Casechek CEO Matt Brandt added that this isn’t a problem any one organization can solve itself. “We believe that great products aren’t built in isolation and could not be more thankful for our fantastic collaboration partners at Northwestern,” he said. “Together, we improved accuracy, eliminated errors and wastes, and streamlined processes to drive down administrative and supply costs to deliver procedural care.”

December 2023 | The Journal of Healthcare Contracting

COMMERCIAL HEALTHCARE PROVIDERS

BY DANIEL BEAIRD

Walmart Health’s Big Push The retail giant is quickly expanding its health centers and offering virtual care to its employees.

With its stated goal of becoming America’s neighborhood health destination,

ChenMed is a prized asset

Walmart Health opened its first center, a 10,000-square-foot facility in Dallas, Ga., in

ChenMed operates over 100 centers across

2019. The large retailer acquired a telehealth provider in 2021 called MeMD and inked

15 states primarily in the Southeast and in

a 10-year deal with UnitedHealth Group in 2022 that aims to drive value-based care

regions where Walmart already operates

adoption for Walmart’s clinicians and launch a new Medicare Advantage plan. By the end

health facilities. It recently tapped United-

of 2022, it had 32 Walmart Health locations.

Healthcare veteran and former CEO Steve Nelson as its president to lead its day-today management and operations. Accord-

As competitors Amazon, CVS Health

have almost 80 Walmart Health centers

ing to Rebecca Springer, lead healthcare

and Walgreens began to acquire physi-

in seven states. Additionally, Bloomberg

analyst for PitchBook, ChenMed is the

cian offices, Walmart Health announced a

reported in September that Walmart is

last scaled, multistate Medicare Advantage

deepening presence in Florida and Texas,

in preliminary talks to acquire ChenMed,

provider group that has not sold to a major

and expansion into new states Missouri

a primary care provider for seniors. The

retailer other than Cano Health, which has

and Arizona. By the end of 2024, it will

deal would be worth billions of dollars.

fallen into financial trouble.

8

December 2023 | The Journal of Healthcare Contracting

A steadfast culture is considered to be

results for employees with diabetes, for

relationship, which is built on a shared

one of ChenMed’s biggest strengths. It’s

example, who saw a 24% reduction on

vision to help Americans gain access to

a privately owned medical and technol-

average in HbA1c levels.

affordable health care options, will initially

ogy company delivering high-touch and

Included Health CEO Owen Tripp

focus on patient engagement through care

personalized primary care for Medicare-

told the HLTH23 conference in October

coordination and referral management,”

eligible seniors. It’s been named a Fortune

that the pilot’s results, which included

the company said.

“Change the World” company and twice

people with hypertension seeing blood

This collaboration marks an ex-

named a “Most Loved Workplace” by

pressure reduced by 14% and total cost

pansion of the existing relationship

Newsweek. Its concierge-style medicine

of care decreased by 11%, dispel the

between Walmart Health and Ambetter

aims to bring better health outcomes to

myths about virtual care that make em-

Health, the largest and longest-running

the neediest populations.

ployers hesitant. He said they found that

carrier on the health insurance market-

ChenMed recently implemented a

33% of those who used the services were

place and one of the leading health care

program to provide each of its patients

over the age of 45. They also saw success

programs provided by Centene Corpo-

with access to the services of a coordinat-

in connecting to patients with chronic

ration. The relationship started earlier

ed team. This coincides with the federal

needs as about 30% of people were seen

this year as the companies collaborated

government’s unwinding of the Public

for either chronic condition management

to enhance awareness of Medicaid rede-

Health Emergency it established dur-

or preventive care.

termination efforts and expand access

ing the Covid-19 pandemic. ChenMed’s patients are generally 65 and older and many live in underserved areas. Its care teams will ensure those who are eligible for Medicaid successfully re-enroll within their particular state’s deadline and retain a variety of vital resources to support their health and wellness needs.

Walmart partnered with Included Health for virtual care collaboration that has produced good results for employees with diabetes, for example, who saw a 24% reduction on average in HbA1c levels.

A deal for ChenMed would be Walmart’s biggest move yet in healthcare. potential bidders could emerge, according

Expanding access in key markets

to Springer, including Optum or a private

In November, Walmart Health announced

“We continue to look for ways to

equity consortium.

it is entering into a relationship with Am-

make health care even more accessible to

better from Sunshine Health, which

the communities we serve,” said Richard

provides insurance to individuals through

Fuchs, senior vice president, sales, strat-

Virtual care expands to Walmart’s employees

the Florida health insurance marketplace,

egy and innovation at Walmart. “Both

and with Orlando Health, a private, not-

Walmart Health and Ambetter Health

Walmart has announced virtual primary

for-profit network of community and

share a focus on serving local communi-

care options for its employees nationwide

specialty hospitals across Florida, through

ties, and this collaboration will enable

after a successful rollout in select states, in-

Care Coordination Agreements.

more Floridians to access care. We’re

But ChenMed is a prized asset and other

to marketplace health insurance within Walmart Health centers.

cluding a $0 copayment for virtual care vis-

Ambetter from Sunshine Health

its. As Walmart’s customers began to adapt

now includes Walmart Health Centers

Health members quality care in one

to a new normal during the COVID-19

as a preferred provider in Clay, Duval,

location, conveniently located adjacent

pandemic, so did its employees. Walmart

Hillsborough, Orange, Osceola, Pasco

to Walmart Supercenters where many

partnered with Included Health for virtual

and Seminole counties in Florida

members already shop for groceries and

care collaboration that has produced good

through the Ambetter Value Plan. “The

everyday essentials.”

The Journal of Healthcare Contracting | December 2023

excited to offer Ambetter from Sunshine

9

COMMERCIAL HEALTHCARE PROVIDERS

BY DANIEL BEAIRD

Amazon’s Reach Extends to Healthcare After many forays into the market, the e-commerce giant acknowledges it can’t do it alone.

Amazon has tried different avenues in its quest to tap into the healthcare market in recent years. It acquired online pharmacy PillPack in 2018 and launched Amazon Care in 2019 as a primary care service for its employees that blended telehealth with in-person medical services. It unveiled Amazon Pharmacy in 2020 offering discounts to Prime members and free delivery. In 2021, Amazon Care expanded to outside employers and added in-person care options in multiple cities, but it shut down last August after struggling to get insurers on board and after Amazon’s acquisition of primary care provider One Medical for $3.9 billion.

Amazon Clinic was launched last No-

One Medical is a membership-based

12 months. Healthcare has seemingly

vember, which is available to people 18 to

primary care practice offering compre-

been its white whale in recent years. Is

64 years of age in all 50 states and Wash-

hensive care in 19 major U.S. markets and

another healthcare acquisition next?

ington, D.C. Customers can use messag-

24/7 access to virtual care. It also works

Amazon’s attraction to One Medical’s

ing to consult a clinician about common

with over 8,500 companies to provide

human-centered, technology-forward

conditions like acne, migraine headaches

One Medical health benefits to their em-

approach could hint at further like-

and hair loss, among other conditions.

ployees. Launched in 2007, it had 836,000

minded additions. Amazon was

It uses third-party vendors and does not

members by the end of 2022.

rumored to be in talks with home

accept health insurance, instead charg-

Senior Vice President of Amazon

healthcare company Signify Health

ing a flat fee, and customers can see their

Health Services Neil Lindsay said Amazon

before CVS Health acquired Signify

medical cost before their visit.

is on a mission to make it dramatically easier

for $8 billion in March.

“Together (with One Medical), we

This January, Amazon introduced Rx-

for people to find, choose, afford and en-

Pass for $5 per month for Prime members

gage with the services, products and pro-

believe we can make the healthcare

to get all their eligible generic prescriptions

fessionals they need to get and stay healthy.

experience easier, faster, more personal

through the e-commerce giant as compa-

“Coming together with One Medical is a

and more convenient for everyone,” said

nies are seeking to drive down the cost of

big step on that journey,” he said in a press

Amazon CEO Andy Jassy.

generics by removing pharmacy benefit

release announcing the acquisition. “One

managers (PBMs) from the supply chain or

Medical has set the bar for what a quality,

One Medical offers:

manufacturing the drugs on their own.

convenient and affordable primary care

` Around-the-clock access through the

experience should be like. We’re inspired

One Medical app.

` On-demand virtual care services like

by their human-centered, technology-

Amazon partnerships

forward approach and excited to help them

Amazon’s Chief Medical Officer Sunita

continue to grow and serve more patients.”

Mishra told Yahoo Finance that the com-

24/7 video chats and in-app messaging.

` Same and next day in-office or remote visits.

` Walk-in availability for on-site

pany will be flexible with its healthcare

What’s next for Amazon and One Medical

laboratory services.

One Medical last July points to Amazon

Amazon is a behemoth with nearly

One Medical memberships are sepa-

just gearing up in the healthcare sector.

$540 billion in revenue during the past

strategy and won’t go it alone.

Its acquisition of San Francisco-based

10

rate from Prime memberships.

December 2023 | The Journal of Healthcare Contracting

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Robotic process automation (RPA) is a

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One large health system leveraged

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ing, copying and inserting data, filling in

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Increasingly, healthcare supply chain teams are working to automate highly

and reports. When coupled with advanced

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artificial intelligence (AI) systems, RPA

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helping to drive rapid synchronization,

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What’s taking up the most time? What’s tedious, inefficient and most frustrating for our

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Research suggests that the average

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Accurate contracts and pricing mean

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And when AI-enabled technology

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ings and resilience.

The Journal of Healthcare Contracting | December 2023

11

12

December 2023 | The Journal of Healthcare Contracting

Martha Bergstedt Vice President of Strategic Sourcing and Contract Management, Novant Health

Jennifer Carlson Senior Director of Strategic Sourcing, Sutter Health

Danielle DiBari Senior VP of Business Operations and Chief Pharmacy Officer, NYC Health + Hospitals

Jennifer Garvin Independent Healthcare Supply Chain Consultant

Roz Holloway General Manager of Resource Optimization & Innovation, LLC (ROi)

Cristina Indiveri Vizient Associate Vice President, Core Tenet Programs, Environmental Sustainability

Karen Niven MS, BSN, CVAHP, Senior Director, Performance Group and Value Analysis, Premier, Inc.

Georgia Denise Robson Clinical Supply Program Senior Director, Supply Chain Services Clinical Alignment Team, Banner Health

Carmen Winfield VP of Supply Chain, McLeod Health

The Journal of Healthcare Contracting | December 2023

13

WOMEN LEADERS IN SUPPLY CHAIN

Martha Bergstedt Vice President of Strategic Sourcing and Contract Management, Novant Health

Can you tell us about your role and responsibilities within your organization?

or drugs. In a normal timeframe, one

small dam. The dam has always worked

of our goals in Strategic Sourcing is to

because it lets a little trickle in while

reduce cost year over year. The unfor-

you’re constantly working on it, but

I am the Vice President of Strategic Sourc-

tunate thing about the market forces

what’s coming in now is much more.

ing and Contract Management for Novant

we’re dealing with is that most of our

You are so busy trying to fix the short-

Health. I have had this role for the last five

third parties are unwilling or unable to

term cracks in the dam but don’t have

years. I lead the team that’s responsible

reduce costs unless there’s some kind

enough resources to handle the long-

for contracting, but at the end of the

of value proposition for them, which

term, increased volume. It’s important

day, it’s setting up the strategy for non-

we have been able to find in many

to keep the team engaged and flexible

labor spend. We’re trying to understand

areas, but not throughout the whole

to address priorities and emergencies,

the value propositions for all our third-

industry. They are suffering from

while building long-term solutions to

party spend, whether or not it’s services,

increased prices and increased costs,

support a completely different delivery

drugs, or supplies. My role is to empower

therefore they’re trying to make sure

of care.

my team to make the best decisions with

they remain relevant.

their clinical and business owners. So, if

But we’re trying to find that win-win,

they’re working well and getting the best

and not just in market share or growth

value, then I figure my job is done.

year over year, which are the traditional

What projects or initiatives are you excited to work on?

levers. What are the key determinants

ERP is something most healthcare

for each one of those industries that is

systems are still trying to figure out. I

important for our third parties? It hasn’t

was in manufacturing 15 years ago and

made our job more complex, just more

we were going through an Oracle ERP

time sensitive.

implementation. In healthcare it seems

What are some leading market forces impacting your supply chain team?

We can’t discount inflation. Then there

The other challenge is the constant

like we’re just catching up. That’s what

are the post-COVID effects continuing to

internal pressure for resources. Layoffs

I think healthcare has been missing for

resonate within our health system.

are a reality for many health systems.

a long time. There’s been a lot of em-

Expenses need to come down,

We have to figure out a way to do what

phasis on clinical support systems, but

whether it’s in labor, contract, supplies,

we do better. Picture a big river and a

back-office supplies, systems that allow

14

December 2023 | The Journal of Healthcare Contracting

WELCH ALLYN AND BAXTER ARE NOW ONE TEAM

THE WAIT IS OVER In a recent Premier survey, hospital and health system staff are spending at least 10 hours a week trying to mitigate supply shortages.1 Quicker lead times can get products to your patients to help cut costs and put the focus back on their needs to help improve outcomes.

We have improved lead times on our vitals, cardiology, vision, and physical assessment products.

Contact a Baxter representative to learn more today.

Most of our Front Line Care products are ready to ship as part of a national promotion. Learn more at hillrom.com/2023rebate.

Reference: 1.

Kacik, Alex, “Supply Chain Shortages to Persist through 2024, Premier Says”, “Modern Healthcare”, June 15, 2023.

Baxter, Hillrom, and Welch Allyn are trademarks of Baxter International Inc. US-FLC157-230046 V1 09/2023

WOMEN LEADERS IN SUPPLY CHAIN

We launched a process that further refines the value equation of outcome improvements compared to cost. We call it Precision.

The goal is to build on the success of clinical variation reduction and look more holistically at care variation with the aim of improving health and reducing cost.

When you hear words like diversity and equity in the workplace, what does that mean to you, and how can they benefit an organization?

where I see those values as important and

So, automation and increased effi-

This needs to be at the forefront of most

ciency are top goals for us. We’ve spent

discussions. I think it’s best used to our

How do you continue to grow as a leader?

the last six months to a year deploying

advantage when we’re intentional about

Seeing the positive even in tough times.

a new ERP system that will consolidate

understanding it. Novant Health has done

The incredible support I’ve gotten from

our HR function, supply chain func-

this for many years. We have used diver-

my team and others has shown me that

tion, and financials. It should make

sity and equity not as a program, but as a

as a leader, it’s important to integrate

things a lot more streamlined, reduce

competitive advantage. This is the way we

their voice into decisions, and be trans-

handoffs, and have less redundancies

make decisions, by recognizing that ev-

parent with the things I know and the

in the processes. It’s a short-term pain

erybody’s coming from a different place,

things I don’t. This has catapulted us to

for a long-term gain. The go-live is next

and intentionally understanding what that

be a lot better and more resilient. I grow

year, so we’ve got a little bit more work

means to help us make the best decisions

and I take a lot of comfort out of hav-

ahead of us.

for all parties.

ing those individual conversations with

for efficiencies – whether or not that’s the basics of transactions, payments, purchase orders, etc. – all that has been neglected for a very long time for many of us.

In addition to technology, our next

Having practices to make sure I have

generation of clinical optimization excites

diverse voices within my team when we’re

me. We launched a process that further

talking about long-term planning, invest-

refines the value equation of outcome

ing, or deciding what type of vendor we

improvements compared to cost. We call

work with. Diversity and inclusion are

it Precision. The goal is to build on the

permeated through most of the decision

success of clinical variation reduction and

making we have.

look more holistically at care variation

It’s important to me because at the

with the aim of improving health and

end of the day, as a woman leader, I want

reducing cost.

to be in a company that I resonate with,

16

we continue to talk about them, and that is certainly what we do.

team members, understanding where everybody else is.

December 2023 | The Journal of Healthcare Contracting

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WOMEN LEADERS IN SUPPLY CHAIN

Jennifer Carlson Senior Director of Strategic Sourcing, Sutter Health

Please tell us about your role/responsibilities within your organization.

shifted more attention to supply chains rate of inflation through creative negotiat-

to you? How can prioritizing these values contribute to the success of an organization?

As the Senior Director of Strategic

ing and more standardization of products

I think of this in two ways:

Sourcing at Sutter Health, my team of

and processes.

First, diversity in our work force adds

to deliver cost reductions and control the

90 employees is responsible for non-labor

varied experiences and perspectives,

expense management initiatives, product and service variation reduction, contracting for goods and services, purchasing, and capital sourcing.

which I believe translate into creative

What are some of the biggest challenges facing supply chain departments today?

problem solving, better decision mak-

From my perspective it is data. Other

to a number of strong female leaders,

ing, and employee retention. During my time in healthcare, I have reported

industries have had data standards like

and I am grateful to have had them as

In what ways has the market changed that makes supply chain more important to hospitals and health systems?

UPCs since the 1970s. In healthcare, we

role models. It was empowering to see

are so far behind on data standards. Even

other women succeed, and it helped

the EMR data we use to review physi-

me have confidence that I could move

cian utilization of medical devices isn’t

into management roles. Healthcare has

Supply chain teams were always valuable,

standard from one hospital to the next.

a high rate of female leaders compared

but often went unnoticed or underappre-

Although we have access to tons of data,

to other industries, but women are

ciated until disruptions in available supply

it is often inaccurate or incomplete. It’s

still underrepresented in top leader-

began to wreak havoc on the world a

challenging to analyze and interpret data

ship positions. Supply chain was also

few years ago. We have had to adapt to a

sets when you have to spend so much

historically very male dominated, and it

regular stream of back ordered and dis-

time normalizing them first.

is exciting to see more women, espe-

continued products and to find solutions

cially in top roles, over the last several

that make sense clinically, financially, and

years. Employees can really benefit

hopefully can be implemented without too much disruption to care teams. Additionally, increased financial pressure has

18

When you hear words like diversity and equity in the workplace, what does that mean

from seeing themselves represented in the leadership roles of their organization. For some, seeing leaders they can

December 2023 | The Journal of Healthcare Contracting

a charter that defines everything from decision criteria to attendance expectations. We have excellent engagement

Challenges present opportunities for growth and supply chains have had unprecedented challenges. Even projects that fail have something to teach us by reflecting on what we could have done differently or analyzing data points that we may need to factor into the next project, for example.

It’s important to fail quickly and move on.

from physicians and I am really proud of how successful this endeavor has been though we continuously look for ways to improve our processes.

How do you focus on your growth as a leader?

As they say, “knowledge is power,” and although I have been in healthcare for 25+ years, I am always learning something new and it’s critical to my growth.

Whether it is through formal education courses or more informal avenues like

What is a recent project or initiative you’ve been excited to work on?

listening to a podcast on healthcare

Second, when I started in Supply

When I came to Sutter there was no

plying it to the work we do.

Chain Management, supplier diversity

established Value Analysis structure

One of my new favorites is LinkedIn

wasn’t widely acknowledged outside of

at the system level; however, a few

Learning. There is a huge library of topics

government agencies. Now it’s become

hospitals were running local product

to choose from, including a lot of supply

a global phenomenon. Supplier diversity

approval committees that Supply Chain

chain focused content that I am very

can create a positive economic impact

was supporting. With executive leader-

excited about for me and my team.

in our local communities by enabling

ship support and partnership with the

job creation and capacity expansion,

clinical service lines, we implemented

is a quote from the movie “A League

increase competition by widening the

CTAC, or the Clinical Technology As-

of their Own” when Tom Hanks

supplier pool, encourage innovation and

sessment Council, which has become a

says “It’s supposed to be hard. If it

entrepreneurship, and increase supply

centralized Value Analysis governance

were easy, everyone would do it.” I

chain resiliency with more sourcing

structure. The subcommittees are service

often prefer to tackle the hard stuff.

options. My team is actively working on

line focused and made up of physicians

Challenges present opportunities for

building out a robust supplier diversity

who review and make approval recom-

growth and supply chains have had un-

plan to grow our spend and measure

mendations for all new medical devices

precedented challenges. Even projects

the impact in the communities we serve.

requested in our system. The physician

that fail have something to teach us by

I have been spending time recently

chair from each subcommittee also sits

reflecting on what we could have done

connecting with peers, resources, and

on the governance committee, along

differently or analyzing data points

various councils to learn best practices

with other clinical and non-clinical lead-

that we may need to factor into the

that my team can adopt rather than re-

ers, where final decisions are made to

next project, for example. It’s impor-

inventing the wheel. I am also currently

approve all new devices. My team facili-

tant to fail quickly and move on. The

pursuing ISM’s Certified Professional

tates by processing all requests, prepping

pandemic has taught us that we have

in Supplier Diversity to strengthen my

agendas and providing cost, revenue,

to be bold, adaptable, and creative; all

own understanding of the concepts.

and contractual impacts. We developed

things I associate with growth.

identify with based on background, culture, ethnicity, gender, etc. can be very motivating and inspirational.

The Journal of Healthcare Contracting | December 2023

reform, there are so many ways we can grow by acquiring information and ap-

The other thing I often think about

19

WOMEN LEADERS IN SUPPLY CHAIN

Karen Niven, MS, BSN, CVAHP Senior Director, Performance Group and Value Analysis, Premier, Inc.

Please tell us about your role/responsibilities within your organization

suppliers to identify and develop strate-

I have worked with IDNs across the

gies to introduce new technology and

country to plan, implement and evaluate

improve product utilization – considering

their structure and Value Analysis pro-

As Premier’s Senior Director of Clinical

care delivery, safety and outcomes as well

grams and processes. And these processes

Value Analysis, my primary responsibility

as total cost.

have evolved and matured – innovative

is to support our members in selecting

Supply Chain teams today are purchasing

high-quality products and services based on

products and services at the right time and the right price, based on the total

Pediatric Value Analysis committee, and

In what ways has the market changed that makes supply chain more important to hospitals and health systems?

use value analysis to support the clinical

In a post pandemic world, I believe Value

developed a priority rate for products and

process within the Premier’s Performance

Analysis has found renewed purpose.

categories that are determined to be criti-

Groups, including the committed SUR-

Ongoing Supply Chain disruptions, cost

cal to operations for patient care. This vi-

PASS® and AscenDrive™ programs.

the best value they bring to an organization and its patients. I lead and facilitate our National Value Analysis Committee, Kiindo™

value of care delivery.

For example, and working closely with our Value Analysis committees, we

pressures and an evolving reimbursement

tal member feedback coupled with robust

I utilize an ongoing Value Analysis

environment have more organizations

data informs Premier’s product watch

process to identify and articulate market

turning to process improvement and lean

list – to provide insights on backorders

requirements that define a product

strategies for ways to find savings, while

and potential shortages, and advocate

category’s attributes for all medical and

simultaneously driving supply chain resil-

for prioritization of critical products.

surgical product categories across our

iency and strong clinical outcomes.

This list is shared with our members as

national portfolio. As a clinical expert, I

During my career, I have had many

well as the White House, FDA and other

understand and have medical expertise

opportunities to lead from the front,

government supply chain stakeholders

to analyze current and future market

middle and the back. I continue to cherish

for their reference and to help prevent

technology trends while prioritizing a

these opportunities and look for ways we

product disruptions in healthcare. I also

healthcare facility’s clinical needs.

can continue to share knowledge, exper-

recently engaged with a team of industry

tise and insights across our industry for

experts who published the Premier 2023

the benefit of all.

Supply Chain Resiliency Guide that offers

Using our Value Analysis program and process, I work with both members and

20

December 2023 | The Journal of Healthcare Contracting

market-informed strategies to address

mindset, it helps make us as individuals,

College of Healthcare Executives, so

supply chain challenges, mitigate risks to

and collectively, more resilient – and it

that we can advance our specialty with

patient safety, and enable long-term suc-

helps spur innovation.

this critical stakeholder group at the

cess for providers.

I am a big believer in the “wisdom of

C-Suite level.

the crowd” – and to accomplish this, we must invite everyone to the table and give

What are some of the biggest challenges facing supply chain teams today?

space for everyone to have a voice and Our mission is to improve the

My career and expertise have led me

Today, clinicians and Supply Chain

health of communities and enhance

to continuously leverage my clinical

leaders must work more closely across

the delivery of patient care. Building a

experience, value analysis knowledge,

departmental lines to understand broader

diverse workforce is vital to fulfilling that

understanding of clinical and operation-

impact and reduce siloed decision making.

mission. Diversity of ideas and input is

al data, and establish relationships with

And Value Analysis professionals should

crucial for healthcare to thrive today and

a wide variety of stakeholders. These

have a seat at the table.

for the future.

skills empower me to remain constantly

share their perspectives.

During times of product disruption,

How do you focus on your growth as a leader?

curious and always learning – and to

product conversions and for every-day,

continue to support other value analysis

and perspective, especially in specialized

What is a recent project or initiative you’ve been excited to work on?

categories, is vital. This can really speed

The development and financial support

Each interaction, every collabora-

up the process for organizations and cre-

of the Niven Education Advancement

tive effort, and the shared expertise

ate efficiencies – and it engenders trust

Scholarship through the Association of

collectively contribute to the ongo-

between Supply Chain and clinicians as

Healthcare Value Analysis Profession-

ing enhancement of healthcare value

well as other key departments throughout

als (AHVAP) is a true example of my

analysis. With deep appreciation and

an organization.

personal and professional commitment

a sense of purpose, I’m committed

high-quality patient care, the ability for supply chain to get clinical expertise

professionals in implementing progressive improvements across the entire healthcare continuum.

An evidence-based Value Analysis

to lifelong learning. I’m thrilled and hon-

to the relentless pursuit of progress,

process can balance issues related to

ored to see this scholarship come to frui-

both in my own professional journey

quality, safety, revenue enhancement, and

tion to encourage and support students

and in the advancement of the broader

reimbursement optimization across the

in our value analysis field.

healthcare industry.

care continuum. It can drive appropriate

I have also recently completed the

utilization and standardization, price opti-

two current AHVAP micro-certifi-

mization and savings, and waste reduction

cations: TeamSTEPPS and Medical

without sacrificing quality.

Device Value Analysis Safety Specialist.

I maintain my CVAHP Certification and serve on the organization’s national

When you hear words like diversity and equity in the workplace, what does that mean to you? How can prioritizing these values contribute to the success of an organization?

Board of Directors, which is charged

When we approach work and life with a

complete my requirements to be eligible

diversity, equity, inclusion and belonging

to become a Fellow in the American

with promoting board certification across our specialty.

I am constantly seeking to learn, develop myself, and grow those around me. My current professional goal is to

The Journal of Healthcare Contracting | December 2023

21

WOMEN LEADERS IN SUPPLY CHAIN

Danielle DiBari Senior VP of Business Operations and Chief Pharmacy Officer, NYC Health + Hospitals

Please tell us a little bit about your role and responsibilities within your organization

development; project and product manage-

face of unexpected disruptions. The abil-

ment; marketing and branding; system strat-

ity to strike the delicate balance between

egies; training and development program

preparedness and fiscal responsibility is a

My role at NYC Health + Hospitals is to

management and delivery; the management

necessity for an organization’s success. It’s

unify and coordinate the health system’s

of multi-functional work teams; and cus-

become more and more challenging as the

business operations, pharmacy and supply

tomer service. This vision-driven approach

availability of raw materials, the products

chain pillars. My main goal is maximizing

has uniquely positioned us to impact our

themselves, and even the ability to trans-

the health system’s ability to positively

organizations’ productivity and long-term

port them is interrupted.

impact the health and well-being of our

success by bringing purpose into the people

Another significant issue for supply

patients and the communities we serve.

equation and promoting healthy, produc-

chain teams is managing the increasing

tive and meaningful work cultures.

complexity of the supply chain itself. The

Being positioned at the critical intersection of business operations and

industry is known to have the greatest

pharmacy with supply chain brings a

expenditure on R&D, and achieving the best possible outcomes for our patients

tunities for strategic innovation and find

What are some of the biggest challenges facing supply chain teams today?

cost-effective solutions to the variety of

The importance of the supply chain in

tions. These rapid advances in medical

challenges facing our health system today.

healthcare has taken on a whole new

technology and therapies are creating

In the end, it enables us to have a signifi-

meaning in the last several years. COVID

new and unexpected challenges to supply

cant impact on organizational productiv-

and its challenges shed a bright light on

chain efficiency in many forms – special-

ity and support long-term success.

the prominent role that supply chain plays

ized storage and shipping requirements,

unique perspective on key business needs.

It facilitates our ability to identify oppor-

is dependent upon staying abreast of the very latest technology and newest medica-

in our ability to deliver safe patient care

hidden costs, or additional regulatory and

multi-functional teams and executing

while managing increasing patient volume

compliance requirements – to name a few.

complex implementations using well-

and keeping costs to a minimum.

This added pressure requires organiza-

Our strength comes from building

developed project plans. My team and I

One of the greatest difficulties facing

tions and their supply chain teams to

focus on every aspect of the businesses

healthcare supply chain teams today is

have a new type of agility and to stay

including strategic planning; business unit

ensuring organizational resilience in the

current with evolving industry standards

22

December 2023 | The Journal of Healthcare Contracting

Our workforce is truly a mirror image of the diverse community we serve. It affords us a unique opportunity to address disparities and reduce discrimination by

Our workforce is truly a mirror image of the diverse community we serve. It affords us a unique opportunity to address disparities and reduce discrimination by bringing a range of opinions and perspectives to problem-solving and helps us achieve our mission.

bringing a range of opinions and perspectives to problem-solving and helps us achieve our mission. It enhances our ability to connect with and understand our patients and improve patient outcomes.

Finally, organizations that champion diversity have been shown to have a stronger reputation. They are better able to attract top talent, helping with recruitment efforts, and leading to a more competitive advantage in the market. Overall, embracing diversity and equity isn’t just a matter of social responsibility, it’s also a

while solving these novel problems and

may exist within the workplace. It goes

strategic imperative for achieving sustain-

continuing to maintain accuracy.

a step further, ensuring access, for both

able success in today’s increasingly diverse

patients and our team members, to the

and dynamic healthcare landscape.

same resources, opportunities and support

When you hear words like diversity and equity in the workplace, what does that mean to you?

to allow them to thrive in their respective

I think of our mission and our workforce

eliminating disparities to foster a workplace

What is a recent project or initiative you’ve been excited to work on?

at NYC Health + Hospitals. The concepts

culture and care environment that allows

Since I joined the health system in Janu-

are baked into the core and mission of our

all individuals to flourish.

ary 2020, the Supply Chain team at NYC

situations. At NYC Health + Hospitals, we strive to be proactive in identifying and

Health + Hospitals has placed a major

health system: “We provide care to every-

focus on developing diversity and equity

one, for anything, at all times, regardless of

in our vendor selection. We’ve signifi-

every race, gender, ethnicity, age, sexual

How can prioritizing these values contribute to the success of an organization?

orientation, and ability in NYC; the mem-

Diversity and equity are included in the

dors who meet the qualifications to over

bers of our health care teams are proud

strategic pillars of NYC Health + Hos-

30%. We are partnering actively with our

representatives of the same communities

pitals and are an enormous area of focus

suppliers to establish a Diverse Supplier

they are honored to serve. Diversity ben-

for the organization. As an organization,

Council to increase interest and participa-

efits everyone, caregivers and patients alike,

we believe that prioritizing diversity and

tion in our program and are taking steps

because it recognizes and values the unique

equity in the workplace will significantly

to support our M/WBE vendors in

perspectives, experiences and contributions

contribute to our success.

expanding their businesses. I’m proud to

their immigration status or ability to pay.”

Our mission recognizes the equal value of

cantly grown our utilization of M/WBE vendors, increasing contract spend to ven-

that each employee brings to the table.

Our priorities are to bring equity to the

share that we received the 2022 Premier

In doing so, it brings us all a step closer

healthcare landscape by providing care to

GPO Supplier Diversity Award for our

toward the equity that we strive to achieve.

everyone and fostering a work environment

community involvement, diversity busi-

Equity goes beyond just diversity by

that is free of discrimination or bias and

ness outreach initiatives, and benchmark-

addressing systemic barriers and biases that

is welcoming to both staff and patients.

ing and sharing of best practices.

The Journal of Healthcare Contracting | December 2023

23

WOMEN LEADERS IN SUPPLY CHAIN

we need to incorporate that thinking into the healthcare supply chain as well.

When you hear words like diversity and equity in the workplace, what does that mean to you? How can prioritizing these values contribute to the success of an organization?

Jennifer Garvin

Being in supply chain, the opportunity to

Independent Healthcare Supply Chain Consultant

drive diversity and equity in the vendor base allows for extending diversity and equity beyond the walls of the workplace and into the communities. Early in my career, I had the opportunity to work alongside leaders that drove a successful Supplier Diversity

Please tell us about your role/responsibilities within your organization.

everyone now knows what PPE stands for.

program. And through this, I was able to see

Since the pandemic’s early days, the im-

and experience how diversity strengthened

portance and prominence of supply chain

not only the supply chain, but the commu-

I am a supply chain leader that has had the

has only risen due to the increase in labor

nities that we serve. That has resonated with

opportunity to work across multiple industries –

expense that all hospitals witnessed along-

me to this day, and I continue to support

allowing me to bring forward expertise and best

side inflation. When labor expense rose, the

initiatives that will build strong programs.

practices from those industries into the health-

financial ask was how to counterbalance and

care setting. My responsibilities have focused on

reduce non-labor expense. This falls within

leadership over all aspects of the supply chain,

the supply chain through strategic negotia-

both contractually and operationally, that has

tions and strong vendor partnerships.

resulted in clinician-integrated initiatives. I

What is a recent project or initiative you’ve been excited to work on?

Throughout my career, I have had the op-

view my role as helping to turn supply chains

portunity to implement multiple supply chain

implementations that revamp the full con-

What are some of the biggest challenges facing supply chain teams today?

tracting and operations processes for greater

One of the biggest challenges facing

and continuous improvement as markets

efficiency, savings and long-term resiliency.

supply chain teams today continues to be

develop and mature. New solutions bring the

shortages and backorders. More transpar-

opportunity to implement change to an orga-

ency from our suppliers on manufacturing

nization. Historically, systems were designed

In what ways has the market changed that makes supply chain more important to hospitals and health systems?

sites and capacity can help supply chains

to be stagnant, but with advancements in

strategically plan from both a contracting

technology happening daily and changes with

and inventory perspective. We need to en-

market pressures, supply chain solutions also

sure continuity of supply, but can only do

need the ability to quickly adjust and adapt

The importance of the hospital sup-

so when we understand the full end-to-end

to reflect those changes. Designing an

ply chain became evident during the

supply chain starting with the raw materials

agile, flexible and highly beneficial solution

COVID-19 pandemic due to pervasive

that begin the manufacturing process. This

in an industry that historically has been

shortages and backorders. Because of that,

is standard practice in other industries, and

inflexible is very invigorating.

into strategic partners – instead of a transactional department – through technology

24

technology and software systems. While this can be a big lift, it also allows for innovation

December 2023 | The Journal of Healthcare Contracting

The The stakes stakes have have changed. changed.

It’s It’s time time to to raise raise the the bar. bar.

In this post-pandemic world, uncertainty is the new normal. Being resilient and In this post-pandemic world, new normal.

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And now — more than ever — you need a reliable partner to support you and your patients every than ever — you need a reliable partner to support you and your patients every step of the way. That’s why we’re redefining supply chain expectations. step of the way. That’s why we’re redefining supply chain expectations.

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WOMEN LEADERS IN SUPPLY CHAIN

Roz Holloway General Manager of Resource Optimization & Innovation, LLC (ROi)

Please tell us about your role/responsibilities within your organization.

ever-evolving healthcare landscape or dur-

and physicians have the necessary re-

ing disruptive periods. I often say, ‘Data

sources to provide the best care for their

should tell the story so we can help find

patients. We do this by taking a unique

As General Manager of Resource Opti-

a solution.’ My primary responsibilities

perspective that combines operations,

mization & Innovation, LLC (ROi), my

focus on product companies, but we also

clinical information and data.

primary role revolves around strengthening

use data to positively impact care at the

supply chain stability and mitigating global

bedside for caregivers.

Clinical operations continuously strengthen the link between products,

supply chain challenges. I achieve this with

usage, clinical efficiency and patient care.

the invaluable support of an exceptional

We’ve observed a growing interest among healthcare systems in engaging in discus-

regulatory compliance, manufacturing, data

In what ways has the supply chain changed what makes value analysis more important to hospitals and health systems?

utilization and global sourcing.

I draw a clear distinction between value

elevate the overall patient experience. We

team of healthcare professionals, each possessing expertise in various aspects of supply chain management, clinical practice,

sions that go beyond individual products.

Their focus is on finding ways to enhance clinician satisfaction and efficiency to

My responsibilities encompass the over-

analysis and clinical operations. While many

are enthusiastic about our well-positioned

sight of our three distinct brands: Regard®

view value analysis as simply the introduc-

role in these discussions and playing a vi-

Medical Supplies, Regard Clinical Packag-

tion of new products, we perceive it as a

tal part in the continuum of patient care.

ing Solutions, and ROi Supply Chain, in ad-

journey that involves data, information,

dition to my role in global sourcing through

clinical expertise and the global supply chain

our international office. In this capacity, I

to ensure we deliver the right solutions.

am entrusted with ensuring the delivery of

We regard value analysis as a core

end-to-end supply chain solutions and an-

responsibility of clinical operations,

ticipating disruption and regulatory impacts

emphasizing its crucial role in the health-

on our customers. This requires orchestrat-

care supply chain and patient care. As a

When you hear words like diversity and equity in the workplace, what does that mean to you? How can they contribute to the success of an organization?

ing a comprehensive approach that not only

provider-owned company, ROi is focused

When I hear words like diversity and equity

addresses their immediate needs, but also

on making healthcare missions possible.

in the workplace, I think of two funda-

positions them for long-term success in the

Fundamental to that is ensuring clinicians

mental principles essential for fostering an

®️

26

December 2023 | The Journal of Healthcare Contracting

Staying well-informed about supply chain and environmental trends, as well as industry developments, is a priority and helps me adapt and lead effectively.

However, a significant part of my growth

The most satisfying reward for us is when we hear from our healthcare partners that the solutions we have jointly collaborated on have been implemented, resulting in increased clinician and/or patient satisfaction at their facilities.

comes from my team and colleagues. We have a brilliant group of individuals who are willing to share, collaborate and mentor. Frankly, they are the most important aspect of my growth, as they bring different perspectives to the table, leading to better decisions overall.

What project or initiative are you looking forward to working on in the next 3-6 months? inclusive environment. Diversity involves

truly had a wonderful support structure

ROi has a unique culture and a team of

recognizing and celebrating differences

throughout my life, from the classroom

professionals from both within and out-

among teammates, creating a mosaic of

to the factory floor, then the office, and

side the healthcare industry. Our passion

talents and ideas. Equity ensures equal

eventually the boardroom. I remember

lies in solving supply chain challenges.

access to opportunities, breaking barri-

the line lead who taught me how to run

The most satisfying reward for us is when

ers and acknowledges that fairness means

a CNC machine at my first job out of

we hear from our healthcare partners that

providing what each person needs to

college, and I am grateful for my current

the solutions we have jointly collaborated

thrive. These principles drive organiza-

team and leaders whom I sincerely respect

on have been implemented, resulting in

tional success through innovation, diversity

and appreciate. I fundamentally believe

increased clinician and/or patient satisfac-

of thought, well-rounded decision-making,

that people want to help each other,

tion at their facilities.

engaged employees and ultimately stronger

which I find inspirational. So, in turn, I

customer relationships. Embracing

carry this philosophy forward in all that I

progress, but the one that excites me

diversity and equity is not just a moral

do to inspire those I work with.

the most is our collaboration with the

We have several exciting projects in

imperative, but also a strategic advantage

If I had to pick one mentor, it would

value analysis teams at key facilities.

for achieving organizational excellence.

be my husband. We’ve been together since

This collaboration aims to implement

Embracing diversity of thought is a dis-

college, starting a family, going through life

a more efficient and repeatable way to

tinction I push within my organization.

overseas and raising our two children into

kit products aligned with the clinical ap-

thriving adults. We’ve had many laughs

proach to treating patients in emergency

and fun moments along the way. He is a

situations. Through our distribution

Has anyone come alongside you to mentor you during your career? If so, can you tell us about that?

great role model, and without his guidance,

channel to the hospital, we can leverage

nothing would have been possible.

all aspects of our capabilities, spanning

I have been very fortunate to be sur-

provide care to our loved ones during

rounded by a supportive family, friends,

How do you focus on your growth as a leader?

great leaders and inspirational colleagues

As a thought leader, I focus on continuous

think of a more exciting and rewarding

and peers throughout my career. I have

learning, self-awareness and collaboration.

initiative to be a part of.

from products to clinical and regulatory expertise. This enables clinicians to

The Journal of Healthcare Contracting | December 2023

their most vulnerable moments. I can’t

27

WOMEN LEADERS IN SUPPLY CHAIN

Cristina Indiveri Vizient Associate Vice President, Core Tenet Programs, Environmental Sustainability

Cristina Indiveri guides the strategy of Vizient’s Environmental Sustain-

efforts are additional global challenges

ability Program while accelerating Vizient’s leadership in sustainability practices

which will require sector-wide collabora-

across healthcare. She collaborates across a wide set of functions to employ solu-

tion. Partnership across the healthcare

tions and insights to reduce negative human and environmental health impacts

ecosystem is taking shape. Providers,

while empowering smart, sustainable, resilient choices. Indiveri also has the honor

suppliers, group purchasing organizations

of facilitating the Environmental Advisory Council, a group of healthcare sustain-

and non-profit organizations are leaning

ability leaders who offer critical strategic guidance in support of Vizient’s broad

in because sustainability offers a robust

Environmental Sustainability objectives and key results.

value proposition by yielding cost savings, increasing supply resiliency, improving efficiency and is essential for public health

In what ways has the market changed that makes supply chain more important to hospitals and health systems?

What are 1-2 of the biggest challenges facing supply chain teams today?

and safety.

One of the greatest challenges facing

In the current market environment,

supply chain teams is the inflationary

supply chain and spend management

market along with ongoing supply

have the ability to drive holistic value

disruptions which are driving up expenses

to provider organizations by making

and creating new economic pressures.

every single dollar go farther. Instead

Approximately half of the hospitals in

When you hear words like diversity, equity and inclusion in the workplace, what does that mean to you? How can prioritizing these values contribute to the success of an organization?

of solely focusing on up-front cost,

the U.S. finished 2022 with a negative

It means all workers can flourish

healthcare organizations can influence

margin as increased expenses outpaced

within the workplace. For me, diver-

and drive performance through

revenue. While there have been many

sity, equity and inclusion equates to

additional value drivers such as

improvements toward stabilizing the sup-

showing up authentically, growing and

supply assurance, supplier diversity

ply chain, the rising tide of expenses will

becoming my best self and having the

and environmental sustainability

continue to be a challenge.

flexibility to fail forward. Diversity, eq-

which improve the health of patients and communities.

28

Secondly, the call to prioritize environmental sustainability and decarbonization

uity and inclusion are critical because in addition to improving employee

December 2023 | The Journal of Healthcare Contracting

As a sustainability professional, I view myself as a change agent within the global healthcare community. My role is to question decisions and evaluate how they will play out in the future. Not only is it essential to focus on current initiatives, but to explore new possibilities and advance towards the “purple unicorn” or imagined, ideal future states.

satisfaction and retention, these are

data transparency and commitment to

and empathy. I try to understand the

drivers of collaboration, creativity, em-

improving public health and safety. Sus-

needs of others in hopes of creating win-

powerment, resilience and adaptability.

tainability and decarbonization require

win scenarios and aligned priorities.

Harvard Business Review found that

commitment from the entire healthcare

Focusing on myself equates to

every 0.1 improvement in DEI ratings for

ecosystem and by participating in this

self-awareness and reflection. It means

a company (on a 5-point scale) was linked

project, the sector is partnering to ensure

listening to my gut to judge decisions.

to a corresponding 13% increase in the

the health of patients, communities, and

While I can attest this method is not

change-power score (ability to change) on

future generations while benefitting from

always foolproof, it can certainly assist

average. If organizations want to increase

social and economic rewards.

in better decision making and lessons

their ability to change (I don’t know one

learned for the future. I try to uphold

company satisfied with the status quo),

these principles to grow – as a leader

DEI are non-negotiable elements of workplace culture.

How do you focus on your growth as a leader?

and a change maker.

I try to keep in mind a multi-pronged approach by focusing on the big picture,

What is a recent project or initiative you’ve been excited to work on?

on others and myself. As a sustainability

To accelerate climate action across the

munity. My role is to question decisions

health care sector, I’m representing

and evaluate how they will play out in

Vizient as an advisory council member

the future. Not only is it essential to fo-

in a new, emerging independent decar-

cus on current initiatives, but to explore

bonization coalition that will include

new possibilities and advance towards

providers, suppliers, and non-govern-

the “purple unicorn” or imagined, ideal

mental organizations. The objective is

future states.

to reduce greenhouse gas emissions through broad-scale collaboration,

professional, I view myself as a change agent within the global healthcare com-

Focusing on others is rooted in building relationships, emotional intelligence

The Journal of Healthcare Contracting | December 2023

29

WOMEN LEADERS IN SUPPLY CHAIN

Carmen Winfield VP of Supply Chain for McLeod Health

Carmen Winfield’s role as Vice President of Supply Chain at McLeod Health is

supply existing products and services to

to provide strategic leadership that drives value and increases resiliency and agility. She is

our customers, as well as the new and

a mentor to her team and responsible for their professional growth. Winfield’s respon-

continue connecting cost, quality, and

sibilities include the distribution of medical and surgical supplies, contracting, purchas-

outcomes for better decision making.

ing, value analysis, strategic sourcing, and retail food services. Her responsibilities also

Multidisciplinary value analysis teams

include the Supply Chain Information Systems team, McLeod Health’s courier program,

are essential to decision making that will

and an on-site laundry service and print shop.

impact our financial health along with the patient outcomes.

Surrounding yourself with different perspectives sparks creativity and helps retain talented employees.

30

In what ways has the supply chain changed that makes value analysis more important to hospitals and health systems?

has been negatively impacted by global

When you hear words like diversity and equity in the workplace, what does that mean to you? How can they contribute to the success of an organization?

supply chain disruptions and high infla-

Diversity means employing people of

tion. Our value analysis teams have been

different ages, genders, and cultural

forced to function as an interconnected

backgrounds. Diversity and equity provide

network, meaning we must partner and

different perspectives in decision making

collaborate internally and externally,

and problem solving and promote col-

including our competitors. McLeod’s ap-

laboration across functional work groups.

proach to value analysis is physician led,

Surrounding yourself with different

evidence based, and data driven. Value

perspectives sparks creativity and helps

analysis has been called upon to guide us

retain talented employees. Supply chain is

through the complexities and volatility.

in a constant state of change; therefore,

They will have to innovate the way we

supply chain professionals must have an

Healthcare organizations cannot afford to work in silos any longer. Our industry

December 2023 | The Journal of Healthcare Contracting

As a supply chain leader, you must make learning a priority and have a plan for professional development. I stay up to date on supply chain and leadership principles and practices by attending and speaking at conferences. Participating in user groups and forums is another avenue for professional growth.

entrepreneurial spirt, be creative, seek

taught me to see the bigger picture. Dale

in the next 3-6 months?

change, go against the grain, take initia-

understood the organization’s complex

Since 2022, McLeod Health has

tive, and have strong opinions. Not ev-

operations, which allowed him to cut

implemented a new ERP, EMR, and

eryone has these attributes, but a diverse

through bureaucracy. He taught me to

POU. Our primary focuses the next 3-6

team allows you to balance the strengths

lead with confidence.

months will be system optimization.

Optimization involves visibility, analyt-

and weaknesses of each other.

ics, and planning. We must gain visibility

Has anyone come alongside you to mentor you during your career? If so, can you tell us about that?

How do you focus on your growth as a leader?

to what our customers need, what they

As a supply chain leader, you must make

our suppliers are producing or not. We

learning a priority and have a plan for

must be working proactively to maximize

are consuming in real-time, and what

professional development. I stay up to

every opportunity. We are drowning in

I had the privilege of working with Dale

date on supply chain and leadership

data; we must leverage the data we have

Locklair for 15 years. He was instru-

principles and practices by attending and

to make better decisions and understand

mental in my success as a supply chain

speaking at conferences. Participating in

the true cost of ownership. And lastly,

leader and taught me to be a strategic

user groups and forums is another avenue

we must improve our ability for accurate

and innovative thinker. Dale and I came

for professional growth. I believe in

demand planning and for inventory,

to McLeod from different industries, but

relationship building and networking with

capacity, and logistic optimization.

we shared results-oriented leadership

internal and external stakeholders, such as

traits. We had a desire to change the way

suppliers, colleagues, healthcare organi-

our organization viewed supply chain

zations, and strategic partners. Reading

and we did this by thinking outside the

supply chain publications and leadership

box. We challenged and questioned the

books is another way I focus on growth.

status-quo internally and externally. Dale empowered me to ask questions, to take initiative and test limits, and seek change.

He embraced my strong opinions and

What project or initiative are you looking forward to working on

The Journal of Healthcare Contracting | December 2023

31

WOMEN LEADERS IN SUPPLY CHAIN

Network (HAN), Women’s Business Enterprise National Council (WBENC),

Georgia Denise Robson

and have participation from our board of Directors on the Pacific Southwest Minority Supplier Development Council (PSWMSDC) and the Arizona Hispanic Chamber of Commerce.

In FY22, 99.8% of Banner Health’s

Clinical Supply Program Senior Director, Supply Chain Services Clinical Alignment Team, Banner Health

diverse spend was with MBEs and WBEs. This is more than twice the Healthcare Anchor Network (HAN) reported average of 38.6%. Banner is also one of 15 IDNs in the country to sign the impact purchasing commitment (IPC).

How can prioritizing these values contribute to the success of an organization?

Please tell us about your role and responsibilities within your organization

What are some of the biggest challenges facing supply chain departments today?

As the Senior Director over the clinical

Rising supply costs and continued prod-

we can have a positive impact on our local

team, I provide clinical leadership to drive

uct disruptions are something we will

economy and community. This fosters

supply chain cost reduction across the

continue to deal with. These issues have

greater collaboration with suppliers and

system assuring achievement of the Supply

placed supply chain in a very visual posi-

can lead to increased positive outcomes.

Chain Strategic Initiative goals of making

tion, and we must work side by side with

healthcare easy, affordable, and reliable.

our clinical stakeholders to ensure we are

By working with local diverse suppliers,

providing safe care for everyone.

What is a recent project or initiative you’ve been excited to work on?

Helping our system move further down

variation and costs through the develop-

When you hear words like diversity, equity, and inclusion in the workplace, what does that mean to you?

ment of consensus supply utilization

We value and celebrate diversity, equity, and

our One team approach and our Banner

programs and initiatives.

inclusion by promoting and cultivating a

Values of Cost Quality and Performance.

I direct and lead the overall strategy, development and implementation of all clinical cost improvement and value analysis work. I oversee the teams that lead multi-disciplinary supply chain services standards teams to decrease product use

the Value Analysis maturity cycle. This will lead to increased clinician and physician engagement in our processes that supports

I also oversee the development of

culturally rich workforce honored to serve,

The Value Analysis process is an inte-

clinical and related operational financial

support, and provide services to our diverse

gral piece of the process that the clinical

performance improvements and outcomes

communities. At Banner we are a tapestry

team in Banner Supply Chain Services

in the areas of Perioperative Services, Car-

of cultures, experiences, and expressions,

uses to determine how we obtain supplies,

diology, Cardiac Cath/EP Lab, Women’s

and we are HERE FOR EVERYONE.

services, and equipment. The process

and Infant Services, Interventional Radiol-

Banner Supply Chain Services em-

strives to balance issues related to quality,

ploys a diversity program manager and

patient and staff safety, revenue enhance-

Finally, I lead and support the new

has an inclusion and outreach program.

ment, and reimbursement optimization

product and technology review process.

We are a member of Healthcare Anchor

across the continuum of care.

ogy, and various procedural areas.

32

December 2023 | The Journal of Healthcare Contracting

THE VALUE OF OUR PORTFOLIO

1

In Plastic Surgery and Regenerative Medicine

Supplier Resiliency Dependable Delivery Versatile Stocking Customer Service Excellence Healthcare systems value the role of supply chain more than ever, and working with a dependable supplier is critical to success. Allergan Aesthetics continues to deliver dependability and the value that you expect from an industry leader.

Reference: 1. Data on file, Allergan Aesthetics, August 2022; Allergan Corporate Healthcare PRM Value Deck. © 2023 AbbVie. All rights reserved.

All trademarks are the property of their respective owners.

MBD162493 05/23 023859

RESILIENCY

Partnering for Optimal Supply Chain Performance If the pandemic ushered in the worst of times for hospital supply chain managers, would a decline in COVID-19 cases bring about the best of times? The reality is that hospitals are still being challenged by ongoing – and unabating – pressures, including raw material and pharmaceutical shortages, declining patient volumes and inflation.

34

By Jon Pruitt, Senior Vice President, CHC Supply Trust

December 2023 | The Journal of Healthcare Contracting

curb supply chain costs has altered how

scrutinizing new contracts to ensure the

hospitals approach GPO partnerships.

best possible terms for the hospital. Sup-

Hospitals hit by supply shortages

ply and service contracts are also figured

during the pandemic now tend to ask

out with automatic annual changes and

what a GPO delivers besides cost savings.

price hikes built into their terms.

Does the GPO have a diversified product

Contracted purchased services also

contracting strategy, for example? Will the

represent savings potential. Often, service

GPO go the extra mile to help hospitals

purchasing is a decentralized process, with

of all sizes procure alternatively sourced

departments contracting on their own

supplies in times of scarcity?

with different providers and missing out

Often, service purchasing is a decentralized process, with departments contracting on their own with different providers and missing out on volume-based discounts.

That’s why strategically minded supply

Supply chain teams are partnering

on volume-based discounts. Hospitals

with hospital leaders and their GPO part-

often overpay for laundry and courier

ners to create a proactive plan for supply

services, for example, due to a lack of

chain disruptions and shortages. A key

centralization and aggregation in the

element is creating a core list of products

procurement process.

that must be available. One example is

Faced with escalating supply chain

an IV catheter. This clinically sensitive

costs and lingering pandemic-related

product is critical to patient care.

apprehensions, some hospitals have

Our client hospitals are convening

taken a noncommittal approach to GPO

clinical committees to evaluate alternative

membership, with some going so far as to

products, adding two selected alternatives

“play the field” by joining multiple GPOs

to the hospital item master, and moving

in an attempt to cherry-pick savings on

chain leaders are focused on resilience –

ahead to train staff to use the alternatives

specific items. This is seldom the best way

due to the pandemic’s exposure of supply

– all before any shortage occurs. This

to leverage group purchasing power and

chain weakness – without losing sight of

effort has become part of daily operating

maximize savings. Instead, this practice

cost-saving opportunities.

procedures for hospitals in the post-pan-

can snarl rather than streamline the pro-

demic environment.

curement process and potentially worsen

Looking to group purchasing organizations (GPOs) for greater stability and sav-

Even as hospitals address ongoing

ings makes sense as a first step. After all, a

shortages, financial pressures remain.

Likewise, hospitals that don’t fully inte-

GPO, by definition, leverages the collective

Supply contracts are an area to identify

grate with a GPO and continue to make large

purchasing power of member hospitals to

potential relief. Many hospitals lack the

purchases on their own might be missing out

secure discounts on goods and services.

resources to monitor contract pricing

on significant cost savings, as well as putting

However, the pandemic changed how

compliance and rely on us to ensure

supply chain consistency at risk – especially

hospitals evaluate GPOs, and the need to

contract adherence while continually

in times of uncertainty and scarcity.

The Journal of Healthcare Contracting | December 2023

cost-control inefficiencies.

35

TRENDS

Urgent Care Rollup More urgent care chains have a triple-digit number of locations than ever before

The number of urgent care centers continues to rise. According to the Urgent

Urgent care bridges the gap be-

Care Association, there are over 14,000 such centers in the U.S. (not including retail clinics),

tween primary care and emergency care,

and the current growth rate for new ones is 7%. Over 78% of the U.S. population lives with-

providing evaluation and care for urgent,

in a 10-minute drive of an urgent care center. As such, they represent a growing opportunity

but not emergent, conditions, according

for distribution. And they’re getting bigger – through consolidation – all the time.

to the UCA. This includes treating minor burns, scrapes and cuts, but also treating conditions such as allergic reactions, ear infections and strep throat. Care volume can be seasonal, typically spiking during late fall and winter, during the respiratory season, correlating to the intensity of the flu, COVID-19, RSV and other respiratory illnesses.

Most centers stabilize and treat fractures and offer onsite X-ray, laboratory and lab services. Where allowed by state law, many centers dispense commonly prescribed pre-packaged medications.

They do not care for life- or limbthreatening situations but do stabilize patients while securing emergency transport. The majority of urgent care centers employ family practice and

Telemedicine and urgent care Urgent care centers’ usage of telemedicine is growing. In the Urgent Care Association’s 2018 Benchmarking Report, only a small fraction of respondents (2%) stated that they offered telehealth services. Just one year later, the 2019 Benchmarking Report released in January 2020 showed the percentage of healthcare centers providing telemedicine grew to 29%.

The pandemic acted as a catalyst for the rapid adoption of telemedicine. In June 2020, 87% of healthcare centers were offering telemedicine services. By 2022, 94% were still offering it as a service. Patients have come to expect this service, according to the association. It is offered not because it is profitable, but to meet patient expectations and stay competitive. The dramatic increase clearly demonstrates the transformative impact of the pandemic on the widespread adoption of telemedicine within the healthcare industry, says UCA.

emergency medicine trained physicians, as well as licensed healthcare professionals, including physician assistants, nurse practitioners, registered nurses and radiology technicians.

Urgent care centers provide laboratory testing both onsite as well as those that can be sent out to regional or national laboratories, says UCA. Examples of available testing may include blood testing services such as Complete Blood Count, Comprehensive Metabolic Profile, diabetic testing (hemoglobin A1c, fingerstick glucose), urine pregnancy, urinalysis, rapid strep throat cultures, and rapid influenza

36

December 2023 | The Journal of Healthcare Contracting

The ‘megacompanies’ owning urgent care is a relatively new phenomenon. testing. Centers also routinely offer tuber-

ownership increased to its levels of nearly

culosis testing; drug screens from urine,

15 years ago, at 52%. Hospital owned/

hair and saliva; and cultures for STIs and

JV growth dropped sharply, from 52% in

urinary tract infections.

2022 to 33% in 2023.

Consolidation is growing in urgent care. “The ‘megacompanies’ owning

Ownership trends

urgent care is a relatively new phenom-

The urgent care industry’s ownership mix

enon,” says Samantha Wulff, communica-

is in a constant state of flux, says UCA.

tions director for UCA. “What made it

These centers emerged largely as a physi-

all possible was private equity interest.

cian or physician group strategy. In 2008,

Scaling up in the industry requires a de-

54% of centers were physician-owned

gree of standardization – everything from

while hospitals represented 25% of the

clinic layouts to staffing levels, and even

total. By 2014, physician ownership had

where various supplies are stored. But it

dropped to 40% and hospital ownership

is a trend, with more urgent care chains

increased to 37% of respondents.

having a triple-digit number of locations

In 2022, ownership by a physician was

than ever before.” As far as integration

reported at 27%, while hospital owned/

goes, according to a 2019 UCA survey,

joint venture centers made up 53%.

nearly 60% of urgent care centers that are

Corporate entity (private equity, insurance

part of a larger health system said they

companies or majority shareholder own-

intended to use the same electronic health

ership) was at 15%. One year later, sole

record system as the hospital, she adds.

Urgent care growth trends COVID introduced many patients to urgent care for the first time, according to the Urgent Care Association. Pre-COVID, a single center saw 32 patients per day, on average. From 2019 to 2020, centers across the United States saw a 60% increase in per-center patient visits. Post-COVID, patients continue to recognize the importance of urgent care, says UCA. The median number of daily visits to a center was 40 in 2022. In fact, year-over-year urgent care center growth continues, as it has since 2014:

` 2014: 7,220 centers ` 2015: 7,983 centers ` 2016: 8,676 centers ` 2017: 9,553 centers

` 2018: 10,484 centers ` 2019: 11,481 centers ` 2020: 12,392 centers ` 2021: 13,306 centers

The Journal of Healthcare Contracting | December 2023

` 2022: 14,075 centers ` 2023: 14,382 centers

Urgent care and the primary care doctor Urgent care appears to be a young persons’ game, raising questions about the continuing role of primary care doctors in the health and well-being of Gen Z and Millennials.

Use of urgent care centers is much higher among Gen Z and Millennial consumers vs. other generations, with approximately 36% of them reporting having used urgent care services in the past six months, according to the Urgent Care Association. In comparison, only 19% of Boomers and members of the Silent Generation used urgent care during the same period. Meanwhile, Gen Z and Millennials have visited urgent care centers more frequently, with 56% and 45%, respectively, having visited more than three times in the prior 12 months, compared to only 26% and 22% of Boomers and Silent Gen. “The goal of urgent care is not to replace primary or other specialized care,” says the UCA. “Urgent care centers are a perfect complement to the [patient-centered-medicalhome] model, and they support primary care practices as an extension of the patient’s clinical team.”

37

TRENDS

Personalized Virtual Care Leading health systems partner with consumer-focused platform for self-insured employers to expand access to patients.

The healthcare industry continues to develop and innovate to meet consumer

across our continuum, in part, by pioneer-

preferences and needs. The pandemic led to wider access to virtual care services, and

ing a range of digital experiences that will

technology has enabled new entrants into the healthcare industry to profit.

make health care easier to navigate, more affordable and more easily accessible for patients across our region.”

One of those companies,

Transcarent’s comprehensive care

Transcarent, has partnered with

model will offer employers and their em-

10 health systems across the nation

ployees a personalized care experience in

to form a virtual provider ecosystem.

the virtual platform in collaboration with

Transcarent is a consumer-directed

each health system. Consumers will also

healthcare platform for self-insured

have access to expert clinical opinions,

employers. With an ecosystem of virtual

virtual physical therapy, orthopedic con-

point solutions, care professionals, and

sultations, a pharmacy marketplace, access

local healthcare facilities, Transcarent

to immediate care quickly (or at home);

aims to make it easier for patients to

Transcarent announced the National

and a cost effective same-day payment

have access to healthcare right from

Independent Provider Ecosystem that

feature unique to Transcarent.

their phone or laptop.

Employers using Transcarent as their companies’ healthcare provider receive competitive pricing previously only reserved for narrow networks. For the first time, members can access virtual care that works together with complex care services delivered locally at hospitals, according to Transcarent.

The brand connects consumers with healthcare information, allowing them

Payment works through a direct-to-

includes health systems such as:

` Advocate Health ` Atrium Health ` Baylor Scott & White Health ` Corewell Health ` Hackensack Meridian Health ` Intermountain Healthcare ` Mass General Brigham ` Memorial Hermann Health System ` Mount Sinai Health System ` Virginia Mason Franciscan Health

employer system that pays providers on the same day care is delivered. Valuebased incentives allow employers receive competitive pricing previously reserved only for narrow networks, while maintaining access for members. Employees benefit from waived co-pays and co-insurance for making better decisions about care.

“We are excited to partner with with Transcarent to provide employers across our

to get care on demand, find in-network

region with better, more convenient access to

providers, locate prescription savings,

“We are proud to be collaborating with

high-quality, value-based care options for

explore care benefits, view lab results,

Transcarent as we accelerate the innovation

their employees,” said David L. Callender,

and access educational content. Trans-

of care delivery models that are transform-

MD, President & CEO for Memorial

carent offers resources that support

ing health care,” says Ketul J. Patel, CEO

Hermann Health System. “We know that

patients with everyday care, surgery,

of Virginia Mason Franciscan Health and

business leaders are a catalyst for improved

at-home physical therapy, comprehen-

president of the Pacific Northwest division

outcomes in health care, and by collaborat-

sive case reviews, support for oncology

of CommonSpirit Health. “This alignment

ing to enhance their employees’ wellness,

care, behavioral healthcare, pharmacy,

expands our commitment to serving our

we can work to improve the health of our

and more.

communities by further integrating care

communities together.”

38

December 2023 | The Journal of Healthcare Contracting

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Frontiers

of the HEALTHCARE SUPPLY CHAIN

Contributed by

Supply Chain By the Numbers

BY JOHN STRONG, CO-FOUNDER AND CHIEF CONSULTING OFFICER, ACCESS STRATEGY PARTNERS INC

Hospital merger sizes are getting bigger Analysis of Kaufman Hall data shows that the smaller sized merger partner in transactions from 2012 to 2022 % Compound Annual Growth Rate.1 have grown at a

11.9

Use of migrant children in dangerous jobs continues According to The New York Times, more than

Drug diversion: A significant national problem

250,000

unaccompanied migrant children entered the United States in the past two years.2 Many of these children are forced to work full or part-time jobs in dangerous conditions while still trying

The recent “The State of Drug Diversion Report” found that

98% of healthcare executives agree that

to go to school. Now, Perdue Farms and Tyson Foods find

drug diversion occurs

themselves under federal investigation for using contractors

in hospitals and

who allow these children to clean and disinfect dangerous meat

believe that most drug

processing equipment at night.

diversion goes undetected.3 The report notes that the problem

Healthcare providers who care about social justice need to

79%

negatively impacts the quality of patient care and patient safety, as

carefully examine who they spend money with, and let these

well as negatively impacting finances. Diversion costs real money.

large companies know they will not tolerate this practice in the

Because of shortages, data from Premier, Inc. shows that

name of higher profits.

40

hospitals spent more than $1.1 billion on substitute products.4

December 2023 | The Journal of Healthcare Contracting

Drugs are not the only things in short supply Unpredictable spot shortages of essential medical supplies continue

These shortages are a cause for real concern, according to a

to plague healthcare supply chains and are not expected to ease for at

recent report by ECRI and are causing harm in a variety of key

least

areas.6 The accompanying chart includes drugs, single use sup-

1 year, according to an Axios report. Among products 5

that are in short supply are surgical mesh, tissue mending products,

plies and other medical devices during a six-month period prior

tourniquet cuffs, body fluid warming solutions, balloon catheters, fetal

to the survey (n=200 respondents). Quality is broadly affected

monitoring devices, chest drains and suction cannisters.

by these shortages in many key areas.

Percent of Respondents Reporting Problems Surgery, Anesthesia Emergency Care Pain Management Cardiology Hematology and Oncology Infectious Diseases Obstetrics and Gynecology 0

20

Kaufman Hall’s recently released “2023 State of Healthcare Improvement: Signs of Stabilization Emerge” notes that

distribution delays (71 ) raw product and sourcing availability (55%) are the only

% and

two supply chain issues over 50% at the present time, based on a recent survey.

7

82% of respondents identified approved

vendor product substitutes

as the leading way to mitigate supply chain shortages.

40

Unfortunately,

60

80

increasing inventory

levels were identified by 57% of respondents as well.

moving to direct purchasing (38%) versus using distribution partners.

More hospitals also reported

305 drugs were in short supply in the third quarter of 2023. According to manufacturers, 56% were for “unknown or refused to provide” reasons by suppliers.8

It’s time we find out what the real reasons are behind short supplies of both medical products and drugs, so that they can be resolved.

Kaufman Hall and Associates ”As Migrant Children Were Put to Work, U.S. Ignored Warnings,” The New York Times, April 17, 2023 3 ”The State of Drug Diversion 2023 Report”, Wolters Kluwer, September 12, 2023 4 Premier, Inc., February 20, 2023 5 “Health Systems Plagued by Shortages Scramble for Essentials,” AXIOS, June 29, 2023 6 “Medication, Supply, Equipment Shortages are Harming Patients,” ECRI.org, October 13, 2023 7 ”2023 State of Healthcare Performance Improvement: Signs of Stabilization Emerge,” Kaufman Hall, October 2023 8 ASHP: Drug Shortages Statistics through Sept. 2023 1 2

The Journal of Healthcare Contracting | December 2023

accessstrategypartners.com

41

Sponsored

Cardinal Health

How your distribution strategy impacts respiratory season stocking According to Paul Farnin, Director of Customer Solutions Team at Cardinal Health, unpredictable seasonal planning takes collaboration between providers, labs, supply chain, and distributors using historical data to identify potential patient volumes and formulary needs for the season.

“In this age of data, a major component to respiratory season is both access to data and ability to convert that data into information. Hospitals are investing money into technology and automation, and on the other side of the equation, customers are getting more savvy in understanding data usage,” said Farnin.

“There is an art that goes with the science when it comes to anticipating needs.”

Some hospitals and health systems have made the decision to self-distribute in the pursuit of greater control and resiliency. Self-distribution, which encompasses anything from buying select products directly from manufacturers to the use of consolidated service centers (CSC) and even sophisticated distribution facilities, is an established trend During respiratory season, unsteady demand and the erratic nature

that gained heightened visibility during

of seasonal viruses and illnesses makes demand planning and inventory

the pandemic, as many organizations

management of critical products such as diagnostic tests a major challenge.

assumed distribution responsibilities and

With high demand and limited supply of these products, many providers need the same

the related costs to ensure critical sup-

products at the same time, and issues like supply constraints, backorders and product

ply of products like personal protective

allocations can run rampant. Secondary issues like lot number tracking and product

equipment (PPE).

dating can also be a risk, as organizations that bring in extra inventory during respiratory season face the possibility of having to throw away expired product.

42

Benefits of self-distribution include consolidation of supply chains, quick

December 2023 | The Journal of Healthcare Contracting

vetting of new suppliers, space savings, and reduction in transport costs. However, with the advantages of centralized supply come the risk of the CSC being a single point of failure, as well as the many challenges that come from managing your own distribution. Disadvantages of self-distribution include the initial capital needed, lack of in-house supply chain talent, and the time and complexity required for implementation.

According to the Health Industry Distributors Association (HIDA)1, organizations considering self-distribution strategies should ask questions including: Will self-distribution add to or detract from patient care? What savings are possible, and does the return offset the cost and risk of such a major initiative? How much risk is the organization willing to assume? And can your organization commit the needed resources for 5-10 years?

Farnin stated, “Since bringing distribution in house, some health systems

a thankless business, not cheap, and

and our distribution capabilities to add

have discovered that distribution is

requires investment over time including

value while managing costs.

Paul Farnin

the startup costs of building a warehouse

To further help our customers

and investing in labor, technology, and

navigate unpredictable demand and

transportation that can quickly grow and

get the critical products their patients

become more expensive.”

need, Cardinal Health is continuously

For organizations considering

investing in distribution solutions like

self-distribution or alternate distri-

Kinaxis® that enable intelligent demand

bution strategies, your distributor

planning and forecasting. We also have

can help you understand all that this

solutions like the Reserved Inventory

decision entails. Because distributors

Program, a unique offering that helps

like Cardinal Health maintain a broad

ensure customers have an identified level

view of the complex ecosystem of

of seasonal diagnostic testing inven-

hospitals, integrated delivery networks

tory available. Ask your Cardinal Health

(IDNs), group purchasing organiza-

Laboratory Representative how your

tions (GPOs), and suppliers, we can

organization can start planning smarter

help healthcare providers leverage data

for respiratory season.

1 Evaluating Self-Distribution: A Guide for Healthcare Executives | White Paper. www.hida.org. Accessed November 8, 2023. www.hida.org/distribution/resources/white-papers/ Evaluating_Self-Distribution.aspx

The Journal of Healthcare Contracting | December 2023

43

HIDA PRIME VENDOR

GETTING THE MOST FROM YOUR MOST IMPORTANT SUPPLIER

Distributors Partner with State and Local Preparedness Officials As a proponent of public-private partnerships, HIDA continues to link stakeholders in the medical supply chain with relevant government agencies focused on preparedness. Recently, HIDA has deepened this commitment with outreach to state and local preparedness and public health officials. These relationships have resulted in the development of useful tools for providers and distributors alike.

Medical product distributors are the essential

` Healthcare distributors were key in last mile

link between global healthcare supply manufacturers

delivery to get PPE and other supplies to providers

and local care providers. HIDA members operate

during the COVID-19 response.

more than 500+ distribution centers to bring critical

` Healthcare distributors collaborated directly

products, supplies, and services to more than 560,000

with federal partners during COVID-19 in a

healthcare settings across the U.S., including hospi-

data-sharing initiative known as the Supply Chain

tals, long-term care, physician practices, home care,

Control Tower.

and laboratories. These critical products such as PPE,

` Healthcare distributors provided subject matter

needles and syringes, lab testing products, infection

expertise on the following tools that assist

prevention products are needed in virtually all public

providers in planning for emergencies and

health emergencies.

assessing their supply chains.

44

Linda Rouse O’Neill; Senior Vice President, Supply Chain Policy, Health Industry Distributors Association

December 2023 | The Journal of Healthcare Contracting

and City Health Officials (NACCHO).

Furthermore, HIDA is collaborating with stakeholders to produce useful resources to advance preparedness goals.

` HIDA has developed a checklist for coordinating with federal, state, and local authorities to ensure access during a disaster. This checklist urges suppliers and distributors to collaborate with providers as well as state and local authorities to identify their needs.

` HIDA provided subject matter expertise to ASPR TRACIE for the Disaster Available Supplies In Hospitals (DASH) tool. This is an interactive tool that helps hospital emergency planners and supply chain staff estimate supply needs during various public health scenarios.

` In collaboration with ASPR, HIDA published a Preparedness Playbook to monitor the medical supply chain and coordinate production and distribution during a public health emergency. Public and private stakeholders developed criteria to determine when the supply chain is in one of three conditions – Steady State

The private sector is scaled to make, source, and distribute medical products to our nation’s healthcare providers across the care continuum. Public partners can provide the planning, funding, and prioritization to create a cohesive response.

(Condition Green), Potential Disruptions (Condition Yellow), or Overwhelmed Supply Chain (Condition Red).

Neither the private sector nor public sector alone possess the full scope of capabilities, infrastructure, funding, nor expertise needed to adequately provide for pandemic preparedness and response in the United States. Instead, supply chain collaboration

HIDA has taken the lead in facilitating

build greater resilience into the medical sup-

can highlight the complementary roles of

relationships between the medical supply

ply chain. In addition to federal leaders from

the commercial supply chain and all levels of

chain and government agencies at the local,

the Administration for Strategic Prepared-

government. The private sector is scaled to

state, and federal levels. The second annual

ness & Response (ASPR) and the Strategic

make, source, and distribute medical products

HIDA Preparedness Summit convened a re-

National Stockpile, the 2023 Summit in-

to our nation’s healthcare providers across

cord number of government partners from

cluded leaders from the Association of State

the care continuum. Public partners can

key agencies with leaders in the healthcare

and Territorial Health Officials (ASTHO)

provide the planning, funding, and prioriti-

distribution industry to discuss efforts to

and the National Association of County

zation to create a cohesive response.

The Journal of Healthcare Contracting | December 2023

45

HSCA

Access to Medications How GPOs prevent and mitigate drug shortages, while providing policy solutions to help combat them.

Drug shortages are an ongoing crisis affecting healthcare providers and patients across the country. Hospitals and patients nationwide are dealing with shortages of critical, life-saving medications and some providers and patients are now being forced to ration necessary medication. In 2022, the University of Utah Drug Information Service (UUDIS) identified a total of 160 national drug shortages. This figure is likely an underestimated amount, however, as many shortages go unreported and may occur in smaller geographic areas. A survey of manufacturers by UUDIS provided insight into the causes of drug shortages, and more than half of the survey respondents (56%) either did not know the cause of the shortage or wouldn’t provide this information.

The U.S. Food and Drug Administration (FDA) identifies manufacturing quality control issues as the primary cause of drug shortages, along with production delays, lack of raw materials, and manufacturer business decisions to discontinue products. As the sourcing and contracting partners to most hospitals, longterm care facilities, surgery centers, clinics, and other healthcare providers across the country, traditional

By Todd Ebert, R.Ph., President and CEO of the Healthcare Supply Chain Association (HSCA)

healthcare group purchasing organizations (GPOs) play an important role in the healthcare supply chain and are leaders in preventing and mitigating drug shortages.

46

December 2023 | The Journal of Healthcare Contracting

GPOs utilize several strategies to mitigate and prevent drug shortages

shortages affecting the healthcare indus-

HSCA recommended transparency

try. The recommendations included:

regarding buffer inventories and that

` Investing in quality and building

input from GPOs and other private

Despite limitations with existing data,

secondary supply lines. HSCA and

industry stakeholders be used to

GPOs track all available data on short-

its member GPOs recommended that

determine which drugs, and if possible,

ages and raw materials, including active

Congress should not only incentivize

which products, should be considered

pharmaceutical ingredients (API). GPOs

production, but also investment in

track this data on a global scale to antici-

quality and capacity, including the

pate any potential supply disruptions and

addition of secondary supply lines and

HSCA recommended that Congress

provide suppliers with notice to plan for

having alternate or backup sources of

encourage FDA to provide 503B

production capability. GPOs identify and

API to support long-term access to

compounding facilities with more

help bring to market additional manufac-

generic medications.

flexibility to meet provider demand

for buffer inventory.

` Mitigating product delays.

turers of critical medications and ensure that there are auxiliary suppliers of essential medications and products.

GPOs identify and source high-quality products at the best value, providing stability and savings across the industry, and work diligently to ensure a robust, competitive, market for healthcare prod-

GPOs encourage competition among suppliers, work to expand the number of suppliers in the market and incentivize them to continue producing essential products and life-saving medications.

ucts by expanding the number of suppliers of essential products and life-saving medications.

` Maintain and/or require buffer

and loosen restrictions to allow 503B

GPOs help create a fair, open, and

inventory. HSCA and its member

compounders to make certain high-risk

competitive marketplace and compete

GPOs recommend that the federal

products in anticipation of a potential

for business based on a variety of factors

government, through the Administration

shortage, rather than only in response

including, but not limited to, supplier

for Strategic Preparedness and Response

product pricing, strength of GPO sup-

(ASPR) and the Strategic National

plier contract terms, breadth of contract

Stockpile (SNS), create, maintain, and/

HSCA recommended that Congress

portfolio, supply chain and clinical ana-

or require buffer inventory for critical

increase funding for and encourage

lytical assistance, and customer service.

medications and devices so there is

the FDA to increase the number

GPOs encourage competition among

always an auxiliary supply available.

of inspections. HSCA further

suppliers, work to expand the number

` Create incentives to increase

recommended that Congress

to an existing shortage.

` Increasing facility inspections.

of suppliers in the market and incentiv-

domestic manufacturing. HSCA

encourage FDA to begin unannounced

ize them to continue producing essential

recommended that if Congress elects

foreign inspections for API suppliers

products and life-saving medications.

to create incentives related to domestic

and drug product manufacturers.

Competition among GPOs is essential to

manufacturing, that the incentives

preventing drug shortages.

be tied to quality and the amount of

HSCA and its member GPOs are

product sold in the U.S. For incentives

committed to mitigating and prevent-

As part of its advocacy approach, the

to tangibly impact pricing dynamics,

ing drug shortages and continuously

Healthcare Supply Chain Association

they must align with quality products

work to determine effective strategies

being made and sold in the U.S.

to ensure that healthcare patients and

(HSCA) and its member GPOs provided a series of recommendations to Congress to further mitigate and prevent drug

` Increasing transparency. Healthcare GPOs are leaders in transparency.

The Journal of Healthcare Contracting | December 2023

providers can access the medications they need.

47

NEWS

Industry News Cleveland Clinic announces expansion of Community Health Workers Program

Premier joins alliance to end drug shortages

Cleveland Clinic announced plans to

End Drug Shortages Alliance, a coali-

expand its Center for Community Health

tion of diverse stakeholders to address

Workers by doubling its staff over the

drug shortages in the United States.

UPMC announces Heart Institute expansion

next month.

The Alliance provides a forum for key

UPMC will construct a new Heart In-

resulting in their removal from the FDA shortage list.

Premier, Inc. announced it has joined the

stakeholders to take strategic aim at one

stitute at UPMC Children’s Hospital of

munity Health Workers is one of the

of healthcare’s more pressing and endur-

Pittsburgh, elevating care and technology

first programs of its kind at an academic

ing issues: drug shortages that disrupt

in pediatric cardiology for patients and

medical center, and the only one to be led

patient care.

their families.

Cleveland Clinic’s Center for Com-

by a certified community health worker.

The End Drug Shortages Alliance was

The Heart Institute will be home to

Community health workers col-

launched in late 2021 to bring together

state-of-the-art clinical space with new

laborate with patients who experience

industry stakeholders, including providers,

cardiac catheterization labs, an interopera-

barriers to accessing medical care and

group purchasing organizations, manu-

tive MRI, inpatient and outpatient pro-

daily essentials such as food, housing,

facturers, distributors and other industry

cedural and diagnostic and consultation

employment and childcare. They play a

thought leaders and champions. Efforts

spaces, plus waiting and reception rooms.

valuable role as facilitators, translators

will focus on improving access to medica-

The new 50,000-square foot, three-story

and advocates, connecting individuals to

tions through greater transparency across

addition will be built on the UPMC Chil-

needed resources.

market participants, leading to improved

dren’s Lawrenceville campus.

Cleveland Clinic’s community health workers are part of the clinical teams within emergency medicine, primary care

quality manufacturing of medications and

UPMC Children’s is a leader in cardiology and heart surgery, ranking

production of additional supply.

For more than two decades, Premier

in the top 10 by U.S. News & World

and its members have been leaders in

Report. Each year, UPMC Children’s

Established in November 2021 by a

preventing and resolving drug shortages.

provides comprehensive care to over

multimillion-dollar gift from the Jones

Through commitment and aggregated de-

18,000 patients with congenital condi-

Day Foundation, the program contin-

mand, Premier’s drug shortage programs

tions throughout their lives, from prenatal

ues to sustain and grow with support

give manufacturers proper demand signal-

through adulthood. As a comprehensive

from philanthropic gifts of all sizes. The

ing, predictable revenue and the surety

pediatric heart transplantation center, and

program has trained 10 community health

needed to ramp up and maintain produc-

a national leader in the use of pediatric

workers and aims to recruit an additional

tion. As a result of Premier’s innovations,

heart-assist devices, the Heart Institute at

10 people from the community to meet

the company has successfully contributed

UPMC Children’s continues to advance

the needs of more patients.

to the resolution of 15 drug shortages,

the field of cardiovascular medicine.

and women’s health.

48

December 2023 | The Journal of Healthcare Contracting

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